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Prognostic outcomes and risk factors for recurrence after laser vaporization for cervical intraepithelial neoplasia: a single-center retrospective study

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Abstract

Background

Cervical intraepithelial neoplasia (CIN) is a precancerous lesion that may progress to invasive cervical cancer without intervention. We aim to examine the prognostic outcomes and risk factors for recurrence after laser vaporization for CIN 3, CIN 2 with high-risk human papillomavirus (HPV) infection, and CIN 1 persisting for more than 2 years.

Methods

Between 2008 and 2016, a total of 1070 patients underwent cervical laser vaporization using a carbon dioxide laser. We performed a retrospective review of their medical records to assess their clinical characteristics, pathologic factors, and prognostic outcomes.

Results

The mean patient age was 34 years (range 18–64 years). The preoperative diagnosis was CIN 1 in 27 patients, CIN 2 in 485 patients, and CIN 3 in 558 patients. Over a median follow-up period of 15 months, the 2-year recurrence rate was 18.9%, and the 5-year recurrence rate was 46.5%. The 2-year retreatment rate was 12.6%, and the 5-year retreatment rate was 30.5%. We diagnosed 9 patients with invasive cancer after treatment; all patients underwent combined multidisciplinary treatment, and there were no deaths during follow-up. The recurrence-free interval was correlated with patient age (hazard ratio [HR], 1.028; 95% CI 1.005–1.051; P = 0.0167), body mass index (HR, 1.052; 95% CI 1.008–1.098; P = 0.0191), and glandular involvement (HR, 1.962; 95% CI 1.353–2.846; P = 0.0004).

Conclusions

Cervical laser vaporization is effective and useful for patients with CIN who wish to preserve fertility. However, patients with glandular involvement, older age, and higher body weight require close follow-up for recurrence.

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Acknowledgements

This study was supported in part by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (Number JP19K09804).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Keisuke Kodama, Hideaki Yahata, Kaoru Okugawa, Hiroshi Tomonobe, Nobuko Yasutake, Sachiko Yoshida, Hiroshi Yagi, Masafumi Yasunaga, Tatsuhiro Ohgami, Ichiro Onoyama, Kazuo Asanoma, Emiko Hori & Kiyoko Kato

  2. Department of Biostatistics, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan

    Mototsugu Shimokawa

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  1. Keisuke Kodama
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Correspondence to Hideaki Yahata.

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Kodama, K., Yahata, H., Okugawa, K. et al. Prognostic outcomes and risk factors for recurrence after laser vaporization for cervical intraepithelial neoplasia: a single-center retrospective study. Int J Clin Oncol 26, 770–776 (2021). https://doi.org/10.1007/s10147-020-01848-x

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